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Remote Utilization Review Rn Jobs in Madison, WI

Varsity Tutors

NCLEX-PN Tutor

Madison, WI · Remote

$18 - $40/hr

... RN scope questions, pharmacology calculations, and managing anxiety with the adaptive testing format. Adapts instruction using NCLEX-PN specific practice question banks, content review focused on ...

Agrace

Benefit & Compensation Analyst (on site)

Madison, WI · Remote

$70K - $87K/yr

Madison, WI Full Time | Day | Monday-Friday | 8am-5pm (option for 1 Day/Week remote) Make a lasting ... This role analyzes market trends, internal data, employee feedback, and program utilization to ...

SHINE Technologies LLC

Licensing Manager

Janesville, WI · On-site +1

$160K - $200K/yr

Hybrid or remote work arrangement will be considered. While our headquarters is located in ... Interface with regulatory agencies in the planning of regulatory engagements, regulatory reviews ...

micro1 AI

Pharmacovigilance Expert

Madison, WI · Remote

$70 - $80/hr

Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... Author and review evaluation tasks based on DSURs, PSURs/PBRERs, and associated safety data and ...

micro1 AI

Clinical Pharmacy Technicians

Madison, WI · Remote

$70 - $80/hr

Remote micro1 is engaging Pharmacovigilance Experts to contribute their advanced drug safety ... Author and review evaluation tasks based on DSURs, PSURs/PBRERs, and associated safety data and ...

SHINE Technologies LLC

Licensing Engineer

Janesville, WI · On-site +1

$73K - $121K/yr

... support of the review of licensing actions by the U.S. Nuclear Regulatory Commission; the ... Hybrid or remote work arrangement will be considered. While our headquarters is located in ...

Varsity Tutors

NCLEX Tutor

Madison, WI · Remote

$25 - $40/hr

Adapts instruction using NCLEX review resources, practice question banks, and clinical scenario analysis to support nursing graduates preparing for first-time licensure as registered nurses or ...

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Remote Utilization Review Rn information

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How much do remote utilization review rn jobs pay per hour?

As of Aug 17, 2026, the average hourly pay for remote utilization review rn in Madison, WI is $42.60, according to ZipRecruiter salary data. Most workers in this role earn between $33.65 and $48.94 per hour, depending on experience, location, and employer.

What is a remote utilization review RN?

A Remote Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients, typically working from a remote location. They review medical records, apply clinical guidelines, and collaborate with healthcare providers to ensure patients receive the right care at the right time. Their work helps manage healthcare costs and improves patient outcomes by preventing unnecessary treatments or hospital stays. Remote Utilization Review RNs often work for insurance companies, hospitals, or healthcare organizations, and use secure digital platforms to conduct their reviews.

What are the key skills and qualifications needed to thrive as a remote utilization review RN?

To excel as a Remote Utilization Review RN, you need a valid RN license, strong clinical judgment, and knowledge of utilization management principles. Familiarity with electronic medical records (EMR), utilization management software, and guidelines such as InterQual or MCG is typically required. Outstanding attention to detail, critical thinking, and effective communication skills help you collaborate with healthcare teams and advocate for appropriate patient care. These competencies are crucial for ensuring medical necessity, regulatory compliance, and optimal resource use in a remote setting.

What are some common challenges remote utilization review RNs face when working from home, and how can they be addressed?

Remote Utilization Review RNs often encounter challenges such as maintaining clear communication with interdisciplinary teams, managing time efficiently, and staying updated on changing payer guidelines. To address these challenges, it's important to establish consistent check-ins with team members via video or chat platforms, use digital tools to organize and prioritize caseloads, and participate in ongoing training sessions provided by employers. Adhering to a structured daily routine and leveraging available technology can help ensure productivity and high-quality reviews while working remotely.

What is the difference between Remote Utilization Review Rn vs Remote Case Manager Rn?

AspectRemote Utilization Review RnRemote Case Manager Rn
CertificationsRN license, Utilization Review certification (e.g., URAC)RN license, Case Management certification (e.g., CCM)
Work EnvironmentReviewing medical records, insurance policies, telehealth platformsCoordinating patient care, discharge planning, telehealth
Employer & IndustryInsurance companies, healthcare organizationsHospitals, insurance providers, healthcare agencies

Remote Utilization Review Rns primarily focus on evaluating medical necessity for insurance coverage, while Remote Case Manager Rns coordinate patient care and discharge planning. Both roles require RN licensure and involve telehealth work, but they serve different functions within healthcare and insurance industries.

What are popular job titles related to Remote Utilization Review Rn jobs in Madison, WI?

For Remote Utilization Review Rn jobs in Madison, WI, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review Rn jobs in Madison, WI look for?

The top searched job categories for Remote Utilization Review Rn jobs in Madison, WI are:

What cities near Madison, WI are hiring for Remote Utilization Review Rn jobs?

Cities near Madison, WI with the most Remote Utilization Review Rn job openings:

Remote Utilization Review Rn jobs near you
Infographic showing various Remote Utilization Review Rn job openings in Madison, WI as of August 2026, with employment types broken down into 76% Full Time, 14% Part Time, and 10% Contract. Highlights an 100% Remote job distribution, with an average salary of $88,617 per year, or $42.6 per hour.

Coding Quality Analyst - Inpatient

UWHealth

Middleton, WI • Remote

Full-time

Medical, Dental, Retirement, PTO

Re-posted 14 days ago

Job description

Work Schedule: 
This is a full time, 1.0 FTE position.  Shifts will be scheduled Monday-Friday.  Hours may vary based on the operational needs of the department. This is a remote position.


To be eligible to work remotely, you must be in an approved remote work state for UW Health. We've included a link below to view the full list of approved remote work states.  
 

Approved Remote Work States Listing

Be part of something remarkable

Join the #1 hospital in Wisconsin!

We are seeking a Coding Quality Analyst to:

  • Assess the accuracy and completeness of the coding of inpatient cases by performing retrospective and concurrent audits and to ensure compliance with coding guidelines and regulatory requirements.
  • Provide feedback to coding team members regarding audit results and respond to coding questions.
  • Assist with the training and onboarding new Inpatient Coders, including auditing.
  • Maintain internal coding guidelines; research, prepare and disseminate information related to official coding guidance updates.
  • Work collaboratively with the Coding and CDI Quality Analyst teams for DRG issues and other operational activities, including internal and external secondary coding reviews.


At UW Health, you will have:

  • An excellent benefits package, including health and dental insurance, paid time off, retirement plans, two-week paid parental leave and adoption assistance. 
  • Options for a variety of schedules and shifts that offer flexibility and allow for work-life balance.
  • Access to great resources through the UW Health Employee Wellbeing Department that supports your emotional, financial, and physical well-being.
  • Tuition benefits eligibility - UW Health invests in your professional growth by helping pay for coursework associated with career advancement.
  • The opportunity to earn a referral bonus for referring friends, former colleagues or others to apply for open, posted positions.
     
Qualifications
  • High School Diploma or equivalent and Medical Coding Program Graduate Required
  • Graduate of a Health Information Technology program Preferred
Work Experience
  • 3 years of progressive acute care hospital inpatient coding experience to include experience coding Medicare DRG's Required
  • More than five years of inpatient coding experience in an academic medical center. Preferred
  • Experience with coding quality improvement projects Preferred
  • Training experience Preferred
Licenses & Certifications
  • Certified Coding Specialist (CCS), or Certified Inpatient Coder (CIC) Required
  • Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA) Preferred
Our Commitment to Social Impact and Belonging
UW Health is committed to fostering a workplace that creates belonging for everyone and is an Equal Employment Opportunity (EEO) employer. Our respect for people shines through patient care interactions and our daily work practices as we work to embrace the knowledge, unique perspectives and qualities each employee and faculty member brings to work each day. It is the policy of UW Health to provide equal opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
Job Description
 
UW Hospital and Clinics benefits
 

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